Special Authorization Analyst II – Clinical Drug Services

This is a fully remote position, open to applicants in Canada.

📋 Description

• Evaluate Special Authorization requests and establish eligibility for requested medication therapies.

• Utilize evidence-based guidelines, clinical expertise, and professional judgment in medication coverage determinations.

• Analyze clinical data, recognized medical conditions, and plan standards.

• Document decision rationale and necessary information in Alberta Blue Cross systems to facilitate claims processing and ensure continuity of member access.

• Craft clinically informed communications for prescribers and members regarding Special Authorization outcomes.

• Address electronic and telephone inquiries from both internal and external stakeholders.

• Articulate decision results, requirements, and subsequent steps in a professional, member-centric manner.

⛳️ Requirements

• Preferred post-secondary qualifications in Pharmacy, Pharmacology, Health Sciences, Nursing, or related clinical fields; experienced Pharmacy Technicians and current special authorization professionals may also be considered.

• Familiarity with pharmacotherapy, medical conditions, treatment protocols, drug reimbursement principles, and clinical decision-making processes.

• Prior experience in Special Authorization, drug benefits management, pharmacy operations, formulary oversight, drug utilization reviews, or health insurance adjudication is preferred.

• Strong analytical capabilities, problem-solving aptitude, and decision-making skills.

• Competence in time management, ability to work autonomously, and contribute to a cooperative team atmosphere.

• High level of precision, attention to detail, and commitment to delivering quality work.

• Proficiency in Microsoft Office, particularly Word and Excel; experience with Access is an advantage.

• Exceptional written and verbal communication skills, complemented by strong organizational capabilities.

• Ability to adapt to shifting priorities and manage competing demands in a dynamic environment.

• Team-oriented individual with a positive and adaptable mindset.

• Service-focused and responsive, with the capacity to build and sustain effective relationships with both internal and external customers.

• Availability to work occasional weekdays until 5:00 pm, as well as weekends and statutory holidays on a rotational basis.

• A satisfactory criminal record check is required as a condition of employment following a conditional offer.

🏝️ Benefits

• Healthy work-life balance.

• Opportunities for professional advancement.

• Dynamic, innovative, and team-oriented work environment.

• An inclusive workplace that welcomes, respects, and values diverse perspectives, backgrounds, and experiences.